THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net


S U M M A R Y


DIARY: June 30, 2010 00:27 AM Wednesday; Rod Welch

Millie letter medical team defer meeting July 1 Dr Johnson at Kaiser.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS A1 0000. ref SDS A0 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 010427 0830 meeting at Kaiser - Doctor Johnson notes Millie looks
040902 - so good nobody can believe she has such severe cancer, ref SDS 47
040903 - OJ6I; the doctor explained again Millie's cancer has mutated through
040904 - 11 relapses to resist chemotherapy.  The doctor advised that Kaiser
040905 - has a new strategy prescribing therapy that is effective for treating
040906 - cancer as a chronic disease by "targeting" the genetic profile of
040907 - cancer that has mutated in patients, like Millie, to resist
040908 - chemotherapy. ref SDS 47 SJ6N
040910 -  ..
040911 - On 100501 1037 Millie letter to medical team confirms understanding of
040912 - new strategy to treat Millie's cancer with targeted therapy.
040913 - ref SDS 48 F25O
040915 -  ..
040916 - On 100501 2017 Doctor Rugo reports plans to collaborate with Doctor
040917 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040918 - of cancer caused by UCSF medical mistakes. ref SDS 49 HH4I
040920 -  ..
040921 - On 100502 2143 Kaiser confirms that some patients respond well to new
040922 - "targeted" therapies. ref SDS 50 YX8L  Kaiser contends that all of the
040923 - strategies for "targeted" therapies have been executed for Millie,
040924 - which seems conflicting with the record in this case. ref SDS 50 MZ4N
040926 -  ..
040927 - On 100503 1522 Millie notifies medical team that time of the essence
040928 - to get the next treatment going. ref SDS 51 TD5W
040930 -  ..
040931 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040932 - with Abraxane chemotherapy that seems to be failing, and then after 3
040933 - more weeks without treatment, following a trip abroad, the doctor will
040934 - discuss "next steps." ref SDS 52 YL5N
040936 -  ..
040937 - On 100503 2338 Millie reports to medical team that she will implement
040938 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040939 - letter on 010503, as assurance that recovery will be equal to changing
040940 - treatment immediately on 100505. ref SDS 53 6X7S
040942 -  ..
040943 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040944 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040945 - communicate with Doctor Johnson, or had already done so, to coordinate
040946 - with Kaiser on planning Millie's next treatment to recover from the
040947 - 11th relapse of cancer. ref SDS 54 NT5N
040949 -  ..
040950 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040951 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040952 - ref SDS 55 KE4K
040954 -  ..
040955 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040956 - seemingly on an accelerating rise, which threatens to cascade out of
040957 - control, because Abraxane chemotherapy is not effective. ref SDS 56
040958 - L54I
040960 -  ..
040961 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040962 - Abraxane. ref SDS 57 KE4K
040964 -  ..
040965 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 58 PK9O
040967 -  ..
040968 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040969 - Department for standard of care to recover from 11th relapse of cancer
040970 - caused by medical mistakes getting radiation treatments at UCSF on
040971 - referral from Kaiser. ref SDS 59 IZ7N
040973 -  ..
040974 - On 100528 0322 Millie requests support from Medicare to separate
040975 - recovery for medical mistakes getting radiation from UCSF, from health
040976 - care benefits limited by Medicare insurance coverage. ref SDS 60 QQ6N
040978 -  ..
040979 - On 100528 1031 called Medicare they have formed a team to review
040980 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040981 - response to Millie's claim. ref SDS 61 4W5F
040983 -  ..
040984 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040985 - collaborate with UCSF on treatment for Millie to recover from UCSF
040986 - medical mistakes.  He discussed treating Millie with MPA, but this was
040987 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040988 - ended the treatment due to fears about blood clot side effects, which
040989 - were believed to cause breathing problems Millie had, though later
040990 - breathing problems were discovered to be caused by defective radiation
040991 - treatment.  Since Doctor Johnson said Kaiser has no more treatments
040992 - for Millie, the only way Millie can get relief from pain caused by
040993 - cancer that is progressing without treatment is get treatment in
040994 - Hospice.  Since Hospice is the only choice of care offered today,
040995 - Millie accepted this.
040997 -  ..
040998 - On 100601 1531 Sharon called to schedule starting Hospice medical
040999 - services beginning tomorrow between 0900 - 1000. ref SDS 48 036C
041001 -  ..
041002 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041003 - Sharon's report yesterday, that if Kaiser performs on the insurance
041004 - agreement to provide standard of care for Millie's patient profile,
041005 - than Millie can elect to recover from 11th relapse of cancer, rather
041006 - than continue with Hospice support for dying peacefully. ref SDS 49
041007 - 036C
041009 -  ..
041010 - On 100602 1046 Diane received notice from Medicare to file claim for
041011 - Millie to get treatment for recovering from UCSF medical mistakes; she
041012 - is preparing a statement of claim. ref SDS 66 036C  Advised Diane to
041013 - use Millie's statement of claim submitted to Kaiser on 100527.
041014 - ref SDS 66 MZ5H  Eileen called later and reported that Kaiser denied
041015 - Millie's claim on the grounds that Medicare does not authorize payment
041016 - for treatment to recover from cancer, after a patient starts Hospice.
041017 - ref SDS 66 UN4M  Requested that Eileen read he claim and then make a
041018 - good faith determiantion. ref SDS 66 I33H  Eileen called back after
041019 - reading the claim and advised the denial of claim has been withdrawn,
041020 - and the matter is referred to Claims Resolution Department.
041021 - ref SDS 66 UN5P
041023 -  ..
041024 - On 100603 0449 Millie notified medical team that Kaiser called today
041025 - about moving forward to resolve medical mistakes getting radiation
041026 - treatment at UCSF on referral from Kaiser. ref SDS 67 IX9Q
041028 -  ..
041029 - On 100606 1604 Doctor Johnson notifies Millie that her cancer marker
041030 - has remained fairly stable the past 3 weeks since ending treatment
041031 - with Abraxane on 100512; actually went up less without Abraxane, than
041032 - with it, because Millie's cancer resists chemotherapy. ref SDS 68 036C
041034 -  ..
041035 - On 100606 1638 Millie thanks Doctor Johnson for submitting good news
041036 - cancer marker CA 15-3 606 much smaller rise than exptected after
041037 - ending treatment for 3 weeks. ref SDS 69 036C; asks if Doctor Rugo ever
041038 - returned Doctor Johnson's call from Kaiser, as planned in Doctor
041039 - Rugo's letter on 100501?
041041 -  ..
041042 - On 100606 2317 Millie receives letter from Doctor Johnson reporting
041043 - that Doctor Rugo has never returned his call asking UCSF for Millie's
041044 - treatment plan, which demonstrates failure to perform on Doctor Rugo's
041045 - commitment in UCSF letter sent to the medical team on 100501.
041046 - ref SDS 70 036C
041048 -  ..
041049 - On 100607 0932 called Cherry at Medicare about progress on contacting
041050 - Kaiser to process Millie's claim filed on 100527, and planned in the
041051 - call with Medicare (Cherry and Beth) as action item #8, planned the
041052 - next day on 100528 1031, ref SDS 61 PE6P; today, Cherry did not have
041053 - time to return the call. ref SDS 71 036C
041055 -  ..
041056 - On 100607 1021 called Paula at Kaiser - she said someone else is
041057 - handling Millie's claim, because the claim has not been denied, and
041058 - Paula only handles denied claims. ref SDS 72 036C; Paula further
041059 - reported that Kaiser no longer objects to demaning UCSF correct
041060 - medical mistakes, so Millie's claim should be easy to resolve.
041061 - ref SDS 72 QN9F
041063 -  ..
041064 - On 100607 1117 letter to Paula confirming Kaiser's work plan to
041065 - process Millie's claim for care promptly in order to save her life.
041066 - ref SDS 73 036C
041068 -  ..
041069 - On 100608 1521 called and talked to Cherry and Beth about expediting
041070 - Millie's claim at Kaiser. ref SDS 74 036C  Developed work plan to have
041071 - a conference call with Kaiser tomorrow. ref SDS 74 C354  Submitted
041072 - letter to Kasier and CMS Medicare confirming work plan for tomorrow.
041073 - ref SDS 74 G84Q
041075 -  ..
041076 - On 100609 1114 called CMS to expedite conference call on expediting
041077 - Millie's care. ref SDS 75 036C  Cherry called and schedule telecon with
041078 - Kaiesr and CMS today 1300. ref SDS 75 8O4H  Received letter from Cherry
041079 - at CMS confirming work plan for conference call at 1300. ref SDS 75
041080 - PRXY
041082 -  ..
041083 - On 100609 1232 letter to CMS and Kaiser submitts agenda for conference
041084 - call to review progress on Kaiser resolving Millie's claim for
041085 - recovery from UCSF medical mistakes. ref SDS 76 036C
041087 -  ..
041088 - On 100609 1300 CMS and Kaiser conference call to report progress on
041089 - reviewing Millie's claim for treatment to recover from UCSF medical
041090 - mistakes in time to be effective. ref SDS 77 036C
041092 -  ..
041093 - On 100609 1522 Jennifer called for assistance processing Millie's
041094 - claim to recover from medical mistakes getting radiation treatment at
041095 - UCSF on referral from Kaiser. ref SDS 78 036C
041097 -  ..
041098 - On 100611 1451 Jennifer advised Kaiser extended the date for
041099 - responding to Millie's claim from 100610 to 100624, based on Millie
041100 - filing updated statement of authorized representative. ref SDS 82 036C
041101 - Jennifer reported she reviewed 6-issues discussed on 100609, and will
041102 - address these issues responding to Millie's claim. ref SDS 82 FQ4G
041103 - Jennifer asked how Kaiser can treat Millie to recover from UCSF
041104 - medical mistakes, if Millie refuses chemotherapy and has entered
041105 - Hospice. ref SDS 82 FQ4M
041107 -  ..
041108 - On 100611 2326 Millie received Jennifer's letter confirming the date
041109 - for Kaiser to respond to Millie's claim has been extended to 100624,
041110 - ref SDS 83 CV4O, and further advising that issues Kaiser will determine
041111 - responding to Millie's claim for recovering from UCSF medical
041112 - mistakes, ref SDS 83 036C, are as set out in the record for telecon on
041113 - 100609. ref SDS 78 XK50  Jennifer will call on 100615, to report
041114 - progress on respnding to Millie's claim. ref SDS 83 6P53
041116 -  ..
041117 - On 100614 0257 letter to Kaiser Medicar CMS claim team requests
041118 - immediate written proposal evaluating treatment options for Millie to
041119 - consider. ref SDS 84 036C
041121 -  ..
041122 - On 100616 0832 called Jennifer about her plan to call yesterday on
041123 - Tuesday to report progress Kaiser responding to Millie's claim, as set
041124 - out in Jennifer's letter on 100611. ref SDS 85 036C   Jennifer called
041125 - back to ask if Millie wants UCSF or Kaiser to pay for her damages
041126 - caused by UCSF medical mistakes. ref SDS 85 PSSV  Jennifer reported
041127 - delays communicating with Millie's medical team have delayed making
041128 - arrangements for Millie to start treatment recovering from UCSF
041129 - medical mistakes. ref SDS 85 OY4T  She plans to call on Friday, 100618,
041130 - to report progress responding to Millie's claim. ref SDS 85 1K5J
041132 -  ..
041133 - On 100618 0843 called Jennifer at Memeber Case Resolution Department
041134 - about progress responding to Millie's claim. ref SDS 86 036C
041136 -  ..
041137 - On 100620 1112 letter to Kaiser claim team with copy to Medicare, and
041138 - the medical team requests call on Monday 100621, planned for previous
041139 - Friday, 100628, to report progress getting Millie treatment.
041140 - ref SDS 87 036C  Recommends that delay communicating with medical team
041141 - that has delayed Millie starting treatment in time to be effective,
041142 - ref SDS 87 L59P, can be solved by hiring MD Anderson. ref SDS 87 L59X
041144 -  ..
041145 - On 100621 0853 called for Jennifer and left several messages,
041146 - including for her team lead. ref SDS 89 036C  Nobody had time today
041147 - for calling back. ref SDS 89 OP3N
041149 -  ..
041150 - On 100622 1027 Jennifer called and advised that Doctor Johnson
041151 - responded to request for comment on Millie's claim saying he cannot
041152 - provide care for Millie because she entered Hospice on 100601,
041153 - ref SDS 91 036C; recommended Jennifer check Kaiser's medical chart for
041154 - Millie meeting with Doctor Johnson to see Millie was given no choices
041155 - except to enter Hospice in order to avoid further pain and suffering.
041156 - ref SDS 91 NX68
041158 -  ..
041159 - On 100622 1511 letter to claim team and Medicare, and to Millie's
041160 - medical team confirming understanding in Jennifer's call that Millie's
041161 - medical team at Kaiser seems to refuse Millie standard of care to
041162 - recover from UCSF medical mistakes, because she was forced to enter
041163 - Hospice to get relief from pain caused by UCSF medical mistakes.
041164 - ref SDS 92 036C  UCSF delays compounded Millie's injuries, pain, and
041165 - suffering; caution must be exercised to enable recovery, based on
041166 - Millie's right to life. ref SDS 92 575U   Millie's patient history
041167 - shows the doctor's only issue, ref SDS 92 576V, is having time to
041168 - providing standard of care for Millie to recover from medical
041169 - mistakes, and if not, then Kaiser should assign someone who does.
041170 - ref SDS 92 583Y  Kaiser has violated Millie's human rights; a woman's
041171 - right to choose life for herself, should be no less than the right to
041172 - choose for her unborn child, since the right to life and due process
041173 - are protected by the US Constitution. ref SDS 92 584W  Kaiser can
041174 - easily solve the time problem by hiring other people to do the work,
041175 - and charging UCSF. ref SDS 92 585P
041177 -  ..
041178 - 100624 1616 Jennifer called and asked to extend Kaiser's response to
041179 - Millie's claim another day or so, for review with her boss, and with
041180 - the customer. ref SDS 93 036C  Jennifer the original date for Kaiser to
041181 - respond on 100610, required by statute, and then amended to today on
041182 - 100624, can be further amended, and cited unclear authority about 30
041183 - days instead of 14. ref SDS 93 EG5P  Agreed that extending Kaiser's
041184 - response another few days until tomorrow, or Monday, is an acceptable
041185 - risk, even though Millie's cancer markier has increased significantly
041186 - to over 1000, and so that an equitable solution can be implented that
041187 - allows treatment in time to be effective for Millie. ref SDS 93 EG73
041188 - Jennifer will submit her draft response, and call tomorrow for
041189 - discussing Kaiser's solution. ref SDS 93 H98M
041191 -  ..
041192 - On 100625 0852 letter to Kaiser and Medicare claim teams confirming
041193 - Kaiser's request to extend date for responding to Millie's claim
041194 - another few days until Monday in order to get comprehensive solution.
041195 - ref SDS 94 036C
041197 -  ..
041198 - On 100626 0917 received letter from Cherry at Medicare, ref SDS 95
041199 - 036C, submitting CMS regulations, that control due date for Kaiser to
041200 - respond to Millie's claim. ref SDS 95 N64I
041202 -  ..
041203 - On 100628 0228 letter to claim teams at Medicare and Kaiser asking how
041204 - CMS regulations received on 100625, apply to extend Kaiser's response
041205 - date for expediting Millie's recovery. ref SDS 96 036C
041207 -  ..
041208 - On 100628 1033 called CMS Medicare for Beth Simone on regulations for
041209 - Kaiser to respond to Millie's claim.
041211 -  ..
041212 - On 100628 2318 submitted record of telecon with CMS, ref SDS 98 036C,
041213 - and that CMS learned today that Kaiser changed Millie's claim to a
041214 - Grievance, and notified CMS that Kaiser intends to delay response
041215 - until 100710, to Millie's claim filed on 100527.
041217 -  ..
041218 - On 100629 00003 received letter from Cherry transmitting Grievance
041219 - procedures, cited in the telecon yesterday as a change Kaiser made to
041220 - delay responding until 100710, to Millie's claim filed on 100527.
041221 - ref SDS 99 036C  Review of Grievance regulations show Kaiser required
041222 - to make timely response based on patient health. ref SDS 99 PN5S
041224 -  ..
041225 - On 100629 0013 letter thanks CMS for submitting regulations on
041226 - Grievance procedures, and notes requirements for Kaiser to respond
041227 - prior to maximum allowed of 30 days, based on patient health.
041228 - ref SDS A0 036C
041230 -  ..
041231 - On 100629 1631 called Medicare (CMS) on results of their
041232 - teleconference with Kaiser on expediting response to Millie's claim.
041233 - ref SDS A1 036C
041235 -  ..
041236 - On 100630 0027 Millie thanks Doctor Johnson for reporting on 100606,
041237 - that UCSF did not call Kaiser to provide care for Millie to recover
041238 - from UCSF medical mistakes. ref SDS 0 036C; she reports blood counts
041239 - are good, but cancer progressing because treatment was stopped on
041240 - 100601, for pain relief from chemotherapy. ref SDS 0 V83U  Kaiser has
041241 - deferred responding to Millie's claim, ref SDS 0 V87S, and needs to
041242 - know how soon her health status requires Kaiser to make a response.
041243 - ref SDS 0 V88T  Millie asks about deferring the meeting with Doctor
041244 - Johnson tomorrow, until Kaiser responds to Millie's claim, or, Millie
041245 - would love to meet, if Doctor Johnson has communicated with Doctor
041246 - Rugo on a work plan for Millie to recover from UCSF medical mistakes.
041247 - ref SDS 0 V89X
041248 -
041249 -
041250 -
041252 -  ..
0413 -
0414 -
0415 - Progress
0416 -
041601 - Millie's letter to medical team says...
041602 -
041603 -    1.  Subject: Work Plan Recover UCSF Mistakes - Defer Meeting Jul 1 Pending Claim Response
041604 -        Date: Wed, 30 Jun 2010 02:19:22 -0700
041620 -         ..
041621 -    3.  Thanks very much for your letter on 100606, reporting UCSF has
041622 -        still not returned your calls on a work plan to recover from
041623 -        medical mistakes getting radiation treatment on Kaiser's
041624 -        referral. ref SDS 70 036C
041626 -         ..
041627 -    4.  Here is background for our meeting scheduled at Kaiser on
041628 -        100701 1140.
041630 -         ..
041631 -    5.  Good news - energy and appetite have improved.  Swelling in my
041632 -        left arm seems entirely resolved, with reduction of general IBC
041633 -        rash.  There are still isolated IBC red dots.  Without
041634 -        treatment, these will fill in of course, based on prior
041635 -        experience.
041637 -         ..
041638 -    6.  More good news - blood counts are very strong, except for
041639 -        platelets, reported for the lab last week on 100622.
041640 -        ref SDS 90 NK7F
041642 -         ..
041643 -    7.  I'm guessing that elevated CBC reflects my body responding to
041644 -        rising cancer, so this lab may be a mixed blessing.
041646 -         ..
041647 -    8.  Bad news - cancer marker CA 15-3 1116 has doubled without
041648 -        treatment [...reported on 100622 0900. ref SDS 90 L54I...].
041650 -         ..
041651 -    9.  Hoping dramatic rise of cancer marker reflects IBC progression
041652 -        in the skin on my right side, noted in your examination on
041653 -        100427. ref SDS 47 FB9Y  It's worse now.  If your analysis on
041654 -        100225, is still apposite that the only problem to solve is in
041655 -        my skin [...reported in the record on 100228 2216. ref SDS 44
041656 -        4Q54...], then there may be a fighting chance to recover from
041657 -        medical mistakes getting radiation treatment at UCSF.
041659 -         ..
041660 -   10.  Anemia has progressed, attributed in Kaiser's medical chart to
041661 -        treatment with chemotherapy [...see for example the meeting on
041662 -        100330 0830. ref SDS 46 FK8H...].
041664 -         ..
041665 -   11.  This aligns with your warning that chemotherapy the past year
041666 -        would not be effective, and that recovery from UCSF medical
041667 -        mistakes requires treatment "targeted" to cancer, shown in
041668 -        patient history beginning on 080829, and listed on 090213.
041669 -        ref SDS 5 PT3N
041671 -         ..
041672 -   12.  I am pleased to report excellent care from Hospice helping me
041673 -        cope with pain from chemotherapy and advancing cancer, pending
041674 -        Kaiser's response to my claim filed on 100527, for relief to
041675 -        recover from UCSF medical mistakes. ref SDS 59 IZ7N
041677 -         ..
041678 -   13.  I also note wonderful care from the Infusion Clinic at Kaiser
041679 -        in Martinez.  Carol and Jo Ann did yeoman's work for my blood
041680 -        draw, and added comments that moved me deeply [...reported
041681 -        on 100622 0900. ref SDS 90 AS5H...]
041683 -         ..
041684 -   14.  You may know that on 100609, Kaiser committed to respond to my
041685 -        claim, on 100610, based on Medicare regulations. ref SDS 77
041686 -        6F64  This was amended to 100624, to allow time for
041687 -        consultation with the medical team [...reported in Kaiser's
041688 -        letter on 100611 2326. ref SDS 83 CV4O...].  Thanks very much
041689 -        for your support [...reported by Kaiser on 100622 1027.
041690 -        ref SDS 91 NX4U, and cited in a letter to Kaiser and Medicare
041691 -        on 100622 1511. ref SDS 92 575R...].  Kaiser, however, has
041692 -        still not responded, nor offered grounds to delay determination
041693 -        on urgent requirement for care.  Sounds familiar - very
041694 -        frustrating and discouraging, though I'm sure everyone is doing
041695 -        their best.
041696 -
041697 -            [On 100630 1148 Doctor Johnson reports being confused about
041698 -            Kaiser's failure to delay determination on Millie's request
041699 -            for urgent care, ref SDS A2 0W4V; since Millie has entered
041700 -            Hospice, he feels this is a desire to forego therapy, and
041701 -            asks if Millie wants to dis-enroll from Hospice.
041702 -            ref SDS A2 PY4J
041704 -             ..
041705 -            [On 100630 1537 Millie notifies medical and claim teams she
041706 -            wants to dis-enroll from Hospice based on Kaiser providing
041707 -            standard of care for Millie to recover from UCSF medical
041708 -            mistakes, responding to Millie's claim filed on 100527,
041709 -            ref SDS 59 IZ7N, and cannot possibly give up pain
041710 -            medication in Hospice until Kaiser demonstrates with
041711 -            written work plan that Millie will be treated to recover
041712 -            from cancer without pain and suffering caused by
041713 -            chemothearpy. ref SDS A3 M93Y
041715 -             ..
041716 -            [On 100701 0915 received call from Carol saying she is
041717 -            Chief of Hospice, and that she was told Millie wants to
041718 -            dis-enroll from Hospice, ref SDS A4 Q85S, which conflicts
041719 -            with the record of notice to Kaiser in the letter on 100630
041720 -            1537. ref SDS A3 M93Y
041722 -         ..
041723 -   15.  Recall, you ordered emergency treatment on 100218, when my
041724 -        cancer was much less severe [...on 100128 cancer marker CA 15-3
041725 -        328; today, CA 15-3 1116, 300% greater...] suggesting delay at
041726 -        this time is much more critical. ref SDS 42 023N
041728 -         ..
041729 -   16.  Rod is helping me work with Kaiser's claim team.  He has
041730 -        notified Kaiser that time is of the essence in this case.  Can
041731 -        you please assist the claim team by estimating my "drop dead
041732 -        date," so Kaiser can allocate resources to resolve the case in
041733 -        time to be effective, based on your report that cancer reaches
041734 -        a point of no return, where the patient cannot be saved,
041735 -        discussed in our meeting at Kaiser on 030606. ref SDS 1 P97J
041737 -         ..
041738 -   17.  When does my [...health status...] require care to avoid losing
041739 -        control of [...cancer...]?  Does the case study comparing
041740 -        treatments and the cancer marker provide evidence to base an
041741 -        estimate, shown on 090323. ref SDS 6 J13O
041742 -
041743 -            [On 100630 1537 Millie's letter responding to Doctor
041744 -            Johnson, notes Kaiser failed to provide essential medical
041745 -            opinion on Millie's health status to guide claim team
041746 -            response to Millie's claim requesting treatment to recover
041747 -            from UCSF medical mistakes; Millie interprets Kaiser's
041748 -            representation that her cancer resists chemotherapy to
041749 -            indicate Millie's health status requires urgent care.
041750 -            ref SDS A3 M96P
041752 -             ..
041753 -            [On 100702 1424 Millie received a letter in the mail
041754 -            dated 100624, from Doctor Johnson transmitting
041755 -            Kaiser's lab report for Millie's blood test on 100622.
041756 -            The doctor provides no analysis, nor comment of any
041757 -            kind except "CA 15-3 1116" is circled in ink.
041758 -            ref SDS A5 NC3F
041760 -         ..
041761 -   18.  Since at this time support from Case Resolution Department, has
041762 -        been deferred, meeting with you on Thursday, could be deferred
041763 -        as well, unless UCSF has submitted a work plan, or your office
041764 -        has ordered standard of care for me to recover from UCSF
041765 -        medical mistakes.  I understood during the meeting with you on
041766 -        100601, that input from UCSF was still deferred from 100501,
041767 -        and as a result, Hospice was my only choice for pain relief.
041768 -        ref SDS 63 4F6I
041769 -
041770 -            [On 100630 1148 Doctor Johnson letter reports being
041771 -            confused about Millie's claim, because Kaiser has failed to
041772 -            respond according to Medicare regulations to provide
041773 -            guidance for the doctor to provide standard of care for
041774 -            Millie to recover from UCSF medical mistakes, indicating
041775 -            Kaiser is not prepared for a productive meeting tomorrow,
041776 -            and therefore the meeting should be deferred. ref SDS A2
041777 -            036C
041779 -         ..
041780 -   19.  My case seems to suffer "chronic deferral."
041782 -         ..
041783 -   20.  If you can provide standard of care, I would love to hear your
041784 -        work plan for PARP or equal, as called out in my claim on
041785 -        100527, ref SDS 59 IZ7N, requesting Doctor Rugo's prescription
041786 -        when "everybody at Kaiser and UCSF was on board" to fix
041787 -        problems providing radiation services at UCSF on referral from
041788 -        Kaiser, reported on 090616. ref SDS 17 D647  Has anything
041789 -        changed since your letter on 100606? ref SDS 70 036C
041791 -         ..
041792 -   21.  Please let me know if we should defer meeting until the Case
041793 -        Resolution Department completes a review, and let us know how
041794 -        long the claim team has based on my health status.
041795 -
041796 -            [On 100630 1148 Doctor Johnson letter reports being
041797 -            confused about Millie's claim, because Kaiser has failed to
041798 -            respond according to Medicare regulations to provide
041799 -            guidance for the doctor to provide standard of care for
041800 -            Millie to recover from UCSF medical mistakes, indicating
041801 -            Kaiser is not prepared for a productive meeting tomorrow,
041802 -            and therefore the meeting should be deferred. ref SDS A2
041803 -            036C
041805 -             ..
041806 -            [On 100630 1148 Doctor Johnson reports being confused about
041807 -            Kaiser's delay determining Millie's request for urgent
041808 -            care, ref SDS A2 0W4V; since Millie has entered Hospice, he
041809 -            feels this is a desire to forego therapy, and asks if
041810 -            Millie wants to dis-enroll from Hospice. ref SDS A2 PY4J
041812 -             ..
041813 -            [On 100630 1537 Millie notifies medical and claim teams she
041814 -            wants to dis-enroll from Hospice based on Kaiser providing
041815 -            standard of care for Millie to recover from UCSF medical
041816 -            mistakes, responding to Millie's claim filed on 100527,
041817 -            ref SDS 59 IZ7N, and cannot possibly give up pain
041818 -            medication in Hospice until Kaiser demonstrates with
041819 -            written work plan that Millie will be treated to recover
041820 -            from cancer without pain and suffering caused by
041821 -            chemothearpy. ref SDS A3 M93Y
041823 -             ..
041824 -            [On 100701 0915 received call from Carol saying she is
041825 -            Chief of Hospice, and that she was told Millie wants to
041826 -            dis-enroll from Hospice, ref SDS A4 Q85S, which conflicts
041827 -            with the record of notice to Kaiser in the letter on 100630
041828 -            1537, ref SDS A3 M93Y; reflect some measure of response at
041829 -            Kaiser to Millie's claim on 100527 for standard of care to
041830 -            recover from UCSF medical mistakes. ref SDS 59 IZ7N
041832 -             ..
041833 -            [On 100710 1343 Kaiser's claim determination dated 100708,
041834 -            disputes no facts in Millie's 32-page claim, and presents
041835 -            no denial of Millie's request for care, presented on
041836 -            100527, ref SDS 59 IZ7N; but neither does the determination
041837 -            notify that Kaiser orders action to hold Millie harmless
041838 -            from UCSF medical mistakes; rather Kaiser offers a sole
041839 -            remedy of Millie meeting and discussing "concerns" with
041840 -            Doctor Johnson, ref SDS A6 X530, which conflicts with
041841 -            Millie's letter today on 100630, saying that after 44 such
041842 -            discussions and written requests for care over the past
041843 -            year, listed on 100622 1511. ref SDS 92 576S, which Kaiser
041844 -            ignored, further discussion can only be productive to
041845 -            implement authority for the doctor to hold Millie harmless
041846 -            from UCSF medical mistakes, ref SDS 0 V89U
041848 -         ..
041849 -   22.  Thanks for always standing up for me, even when things seem
041850 -        very mixed up.
041851 -
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0419 -